自我管理行为在中青年2型糖尿病患者知觉压力与焦虑、抑郁间的中介效应

The mediating effect of self-management ability on stress perception,anxiety and depression in young and middle-aged patients with type 2 diabetes

目的分析中青年2型糖尿病患者自我管理行为、知觉压力与焦虑、抑郁之间的相互作用,为缓解患者焦虑、抑郁情绪提供指导。方法采取便利抽样法纳入2021年12月至2022年6月于宿迁市第一人民医院就诊的中青年2型糖尿病患者198例,使用一般资料调查问卷、糖尿病自护行为量表、知觉压力量表、焦虑自评量表、抑郁自评量表对患者进行横断面调查。采用Pearson相关分析患者自我管理行为、知觉压力与焦虑、抑郁的相关性,构建患者自我管理行为在知觉压力与焦虑、抑郁间的结构模型。结果回收有效问卷185份。185例患者中,男102例,女83例,年龄(39.09±5.36)岁。患者自我管理行为得分(15.79±1.34)分,知觉压力得分(36.46±10.53)分,焦虑得分(47.39±7.47)分,抑郁得分(52.35±8.50)分。患者知觉压力与焦虑、抑郁呈正相关(r=0.779、0.932,均P<0.05),自我管理行为与知觉压力呈负相关(r=-0.656,P<0.05),自我管理行为与焦虑、抑郁呈负相关(r=-0.631、-0.684,均P<0.05)。自我管理行为在患者知觉压力与焦虑间存在部分中介效应,占总效应的17.72%;自我管理行为在患者知觉压力与抑郁间存在部分中介效应,占总效应的20.92%。结论中青年2型糖尿病患者普遍压力较大,焦虑、抑郁情绪较高,且知觉压力可直接影响其焦虑、抑郁程度,也可通过自我管理行为的中介作用间接影响患者的焦虑、抑郁程度,可通过加强患者自我管理行为减轻其焦虑、抑郁程度。

Objective To analyze the interaction between self-management ability,stress perception,anxiety and depression in young and middle-aged patients with type 2 diabetes,and provide guidance for relieving anxiety and depression.Methods A total of 198 young and middle-aged patients with type 2 diabetes who were treated in the First People′s Hospital of Suqian City from December 2021 to June 2022 were included by convenience sampling method.The general information questionnaire,Self-Behavior Management Scale for Diabetic Patients,Stress Perception Scale,Self-rating Anxiety Scale and self-rating Depression Scale were used to investigate the patients.Pearson correlation was used to analyze the correlation between patients′self-management ability,perceived stress and anxiety and depression,and to construct a structural model of patients′self-management ability in perceived stress,anxiety and depression.Results Finally 185 valid questionnaires were collected.The mean age of the patients was(39.09±5.36)years old,with 102 males and 83 females,respectively.The patients′self-management ability was(15.79±1.34)points,stress perception(36.46±10.53)points,anxiety(47.39±7.47)points,depression(52.35±8.50)points.Stress perception was positively correlated with anxiety and depression(r=0.779,0.932,both P<0.05),while self-management was negatively correlated with stress perception(r=-0.656,P<0.05),and self-management was negatively correlated with anxiety and depression(r=-0.631,-0.684,both P<0.05).There was a partial mediating effect between stress perception and anxiety,accounting for 17.72%of the total effect.There was a partial mediating effect between stress perception and depression,accounting for 20.92%of the total effect.Conclusions Middle-aged and young people with type 2 diabetes generally have greater stress and higher anxiety and depression,and perceived stress can directly affect the degree of anxiety and depression,and perceived stress can indirectly affect the degree of anxiety and depression through the mediating role of self-management ability,and can reduce the degree of anxiety and depression by strengthening the self-management ability of patients.